1. FIELD OF THE INVENTION
This invention relates generally to prosthetic strips for surgery, and, more particularly to a strip or patch having pockets used to suspend prolapsed anatomical structures and repair torn ligaments or tendons.
2. DESCRIPTION OF THE RELATED ART
Prosthetic strips are used in a variety of surgical applications. They may be used to repair torn tendons or ligaments, or they may be used to suspend prolapsed anatomical structures, such as the bladder, vagina, or rectum. To repair torn tendons or ligaments or to suspend prolapsed anatomical structures, a prosthetic strip is used to pull tissue in a desired direction.
Laparoscopic Retropubic Urethropexy ("the LRU procedure") is one application in which prosthetic strips are used. As illustrated in FIG. 1, the LRU procedure involves lifting the bladder neck to alleviate stress urinary incontinence, a symptom often occurring in postpartum women. Specifically, two prosthetic strips are used, one on each side of the bladder. For each prosthetic strip, one end of the prosthetic strip is attached to tissue alongside the bladder neck, and the other end of the prosthetic strip is attached to Cooper's ligament. This pulls upon the bladder neck, thereby changing the angle of the bladder neck relative to the bladder.
According to one known method for performing the LRU procedure, a surgeon inserts an endoscope into the preperitoneal cavity formed by balloon dissection adjacent the bladder, so that the surgeon can view the area in which the procedure is to be performed. The surgeon then places one end of a prosthetic strip on tissue next to the bladder neck. While holding the prosthetic strip in place with a laparoscopic grasper, the surgeon attaches the prosthetic strip to the tissue next to the bladder neck. A fastener tool, such as a tacker or a stapler, is used to attach the prosthetic strip to the tissue. After one end of the prosthetic strip is tacked to the tissue, the other end of the prosthetic strip is positioned on Cooper's ligament and held in place with the laparoscopic graspers while it is tacked to Cooper's ligament with the tacker. This procedure is described in greater detail in the article "Laparoscopic Retropubic Urethropexy," by Stanley L. Hannah, M.D. and Albert Chin, M.D., The Journal of the American Association of Gynecologic Laparoscopists, Vol. 4, No. 1, pp. 47-52, the contents of which are fully incorporated by reference herein.
The above described procedure requires a surgeon to make three incisions in the patient. The first incision is to insert the endoscope, the second incision is to insert the laparoscopic graspers, and the third incision is to insert the fastener tool. It is desirable to reduce the amount of incisions made because incisions can leave scars and because postoperative pain increases as the numbers of incisions increase. Therefore, it is desirable to have a prosthetic strip which can be held in place without laparoscopic graspers so that incisions are required only for the endoscope and the tacker.